Skip to Content

Cipro Dosage

Generic name: CIPROFLOXACIN HYDROCHLORIDE 250mg
Dosage form: tablets, oral suspension

See also:

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

CIPRO Tablets and Oral Suspension should be administered orally as described in the appropriate Dosage Guidelines tables.

Dosage in Adults

The determination of dosage and duration for any particular patient must take into consideration the severity and nature of the infection, the susceptibility of the causative microorganism, the integrity of the patient’s host-defense mechanisms, and the status of renal and hepatic function.

Table 1: Adult Dosage Guidelines
 
Infection
 
Dose
 
Frequency
 
Usual Durations
     
 
Skin and Skin Structure
 
500–750 mg
 
every 12 hours
 
7 to 14 days
     
 
Bone and Joint
 
500–750 mg
 
every 12 hours
 
4 to 8 weeks
     
 
Complicated Intra–Abdominal
 
500 mg
 
every 12 hours
 
7 to 14 days
     
 
Infectious Diarrhea
 
500 mg
 
every 12 hours
 
5 to 7 days
     
 
Typhoid Fever
 
500 mg
 
every 12 hours
 
10 days
     
 
Uncomplicated Urethral and Cervical Gonococcal Infections
 
250 mg
 
single dose
 
single dose
     
 
Inhalational anthrax (post-exposure)
 
500 mg
 
every 12 hours
 
60 days

4 to 8 weeks

 
Plague 3
 
500–750 mg
 
every 12 hours
 
14 days
     
 
Chronic Bacterial Prostatitis
 
500 mg
 
every 12 hours
 
28 days
     
 
Lower Respiratory Tract Infections
 
500–750 mg
 
every 12 hours
 
7 to 14 days
     
 
Urinary Tract Infections
 
250–500 mg
 
every 12 hours
 
7 to 14 days
     
 
Acute Uncomplicated Cystitis
 
250 mg
 
every 12 hours
 
3 days
     
 
Acute Sinusitis
 
500 mg
 
every 12 hours
 
10 days
     

Conversion of IV to Oral Dosing in Adults

Patients whose therapy is started with CIPRO IV may be switched to CIPRO Tablets or Oral Suspension when clinically indicated at the discretion of the physician (Table 2) [see Clinical Pharmacology (12.3)].

Table 2: Equivalent AUC Dosing Regimens

CIPRO Oral Dosage

Equivalent CIPRO IV Dosage

250 mg Tablet every 12 hours

200 mg intravenous every 12 hours

500 mg Tablet every 12 hours

400 mg intravenous every 12 hours

750 mg Tablet every 12 hours

400 mg intravenous every 8 hours

Dosage in Pediatric Patients

Dosing and initial route of therapy (that is, IV or oral) for cUTI or pyelonephritis should be determined by the severity of the infection. CIPRO should be administered as described in Table 3.

Table 3: Pediatric Dosage Guidelines
Infection Dose Frequency Total Duration

Complicated Urinary Tract or Pyelonephritis

(patients from 1 to 17 years of age)

10 mg/kg to 20 mg/kg

(maximum 750 mg per dose; not to be exceeded even in patients weighing more than 51 kg)

Every 12 hours

10–21 days

Inhalational Anthrax (Post-Exposure)2

15 mg/kg

(maximum 500 mg per dose)

Every 12 hours

60 days

Plague2,3

15 mg/kg

(maximum 500 mg per dose)

Every 8 to 12 hours

10–21 days

Dosage Modifications in Patients with Renal Impairment

Ciprofloxacin is eliminated primarily by renal excretion; however, the drug is also metabolized and partially cleared through the biliary system of the liver and through the intestine. These alternative pathways of drug elimination appear to compensate for the reduced renal excretion in patients with renal impairment. Nonetheless, some modification of dosage is recommended, particularly for patients with severe renal dysfunction. Dosage guidelines for use in patients with renal impairment are shown in Table 4.

Table 4: Recommended Starting and Maintenance Doses for Adult Patients with Impaired Renal Function

Creatinine Clearance (mL/min)

Dose

> 50

See Usual Dosage.

30–50

250–500 mg every12 hours

5–29

250–500 mg every 18 hours

Patients on hemodialysis or Peritoneal dialysis

250–500 mg every 24 hours (after dialysis)

When only the serum creatinine concentration is known, the following formulas may be used to estimate creatinine clearance:

Men - Creatinine clearance (mL/min) = Weight (kg) x (140–age)

72 x serum creatinine (mg/dL)

Women - 0.85 x the value calculated for men.

The serum creatinine should represent a steady state of renal function.

In patients with severe infections and severe renal impairment, a unit dose of 750 mg may be administered at the intervals noted above. Patients should be carefully monitored.

Pediatric patients with moderate to severe renal insufficiency were excluded from the clinical trial of cUTI and pyelonephritis. No information is available on dosing adjustments necessary for pediatric patients with moderate to severe renal insufficiency (that is, creatinine clearance of < 50 mL/min/1.73m2).

Important Administration Instructions

With Multivalent Cations

Administer CIPRO at least 2 hours before or 6 hours after magnesium/aluminum antacids; polymeric phosphate binders (for example, sevelamer, lanthanum carbonate) or sucralfate; Videx® (didanosine) chewable/buffered tablets or pediatric powder for oral solution; other highly buffered drugs; or other products containing calcium, iron or zinc.

With Dairy Products

Concomitant administration of CIPRO with dairy products (like milk or yogurt) or calcium-fortified juices alone should be avoided since decreased absorption is possible; however, CIPRO may be taken with a meal that contains these products.

Hydration of Patients Receiving CIPRO

Assure adequate hydration of patients receiving CIPRO to prevent the formation of highly concentrated urine. Crystalluria has been reported with quinolones.

Instruct the patient of the appropriate CIPRO administration [see Patient Counseling Information (17)].

Directions for Reconstitution of the CIPRO Microcapsules for Oral Suspension

CIPRO Oral Suspension is supplied in 5% (5 g ciprofloxacin in 100 mL) and 10% (10 g ciprofloxacin in 100 mL) strengths. CIPRO oral suspension is composed of two components (microcapsules and diluent) that must be combined prior to dispensing.

Table 5: Appropriate Dosing Volumes of the Reconstituted Oral Suspensions

Dose

5%

10%

250 mg

5 mL

2.5 mL

500 mg

10 mL

5 mL

750 mg

15 mL

7.5 mL

Preparation of the suspension:

Step1

Step 1

The small bottle contains the microcapsules, the large bottle contains the diluent.

Step 2

Step 2

Open both bottles. Child-proof cap: Press down according to instructions on the cap while turning to the left.

Step 3

Step 3

Pour the microcapsules completely into the larger bottle of diluent. Do not add water to the suspension.

Step 4

Step 4
4.
Remove the top layer of the diluent bottle label (to reveal the CIPRO Oral Suspension label). Close the large bottle completely according to the directions on the cap and shake vigorously for about 15 seconds. The suspension is ready for use.

Step 5: Write the expiration date of the re-constituted oral suspension on the bottle label.

Reconstituted product may be stored below 30°C (86°F) for 14 days. Protect from freezing.

No additions should be made to the mixed final ciprofloxacin suspension. CIPRO Oral Suspension should not be administered through feeding or NG (nasogastric) tubes due to its physical characteristics.

Hide